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Clarification on NICU level of care authorization program

December 12, 2023

This article is for managers of intake, utilization review, and case management at acute care hospitals

Thank you for submitting your requests for NICU level of care authorizations for premature and medically complex infants to ProgenyHealth. Please use the chart below to determine when to submit a request to ProgenyHealth.

If the baby is	Then
Discharged at the same time as the mother	No submission is required
Staying longer than the mother (Level 1)	Submit inpatient notification to Blue Cross: Phone: 1-800-327-6716 Fax: 1-866-577-9678 Submit surgical or outpatient services notification to Blue Cross: Fax: 1-888-282-0780
Medically complex and/or premature and requires Level 2 and above care Transferred to another facility’s NICU	Submit your request to ProgenyHealth: Phone: 1-888-832-2006 Fax: 1-866-303-5749

If the baby is

Then

Discharged at the same time as the mother

No submission is required

Staying longer than the mother (Level 1)

Submit inpatient notification to Blue Cross:

Phone: 1-800-327-6716
Fax: 1-866-577-9678

Submit surgical or outpatient services notification to Blue Cross:

Fax: 1-888-282-0780

Medically complex and/or premature and requires Level 2 and above care

Transferred to another facility’s NICU

Submit your request to ProgenyHealth:

Phone: 1-888-832-2006
Fax: 1-866-303-5749

To read more about this program, which we offer to our members at no additional cost, log in and go to News. Scroll down to the News Alert dated May 4, 2023: "Progeny will support premature and medically complex infants."

Resources

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